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公开(公告)号：US6123084A
公开(公告)日：2000-09-26
申请号：US216283
申请日：1998-12-18
CPC分类号： A61B18/08 , A61B2017/003 , A61B2018/00392 , A61B2018/00738 , A61B2018/1475
摘要： A method for improving blood flow in the heart provides a catheter system with an outer catheter defining at least one lumen and an inner catheter defining at least one lumen with proximal and distal portions. An introducer is coupled to the distal portion of the inner catheter. The introducer has a tissue piercing distal end. A resistive heater element is positioned in the introducer. The catheter system is introduced into a patient's vasculature. The inner catheter is then introduced through the a lumen of the outer catheter to a selected heart site. The tissue piercing distal end of the introducer is then advanced into an interior of the heart at the selected heart site. Energy is delivered to the selected heart site from the resistive heater element to create a blood conducting pathway and/or stimulate angiogenesis. In an alternative embodiment, a heart treatment apparatus is provided that includes a handpiece with a proximal and a distal end and an elongated member defining at least one lumen coupled to the handpiece distal end. The elongated member has a distal end and an introducer coupled to the distal end. The introducer has a tissue piercing distal end. A resistive heater element is positioned in the introducer. The tissue piercing distal end is introduced through a port in the chest wall into a chest cavity and through an epicardial surface of the heart wall to a selected site within the heart. Energy is delivered to the selected heart site from the resistive heater element to create a blood conducting pathway and/or stimulate angiogenesis.
摘要翻译： 用于改善心脏中的血液流动的方法提供了一种具有限定至少一个内腔的外导管和限定具有近端和远端部分的至少一个内腔的内导管的导管系统。 引导器联接到内导管的远端部分。 导引器具有组织穿刺远端。 电阻加热器元件位于导引器中。 将导管系统引入患者的脉管系统。 然后将内导管通过外导管的内腔引入选定的心脏部位。 然后导引器的组织穿刺远端在选定的心脏部位进入心脏的内部。 能量从电阻加热器元件输送到选定的心脏部位以产生血液传导途径和/或刺激血管发生。 在替代实施例中，提供了一种心脏治疗装置，其包括具有近端和远端的手持件以及限定连接到手持件远端的至少一个腔的细长构件。 细长构件具有远端和连接到远端的导引器。 导引器具有组织穿刺远端。 电阻加热器元件位于导引器中。 组织穿刺的远端通过胸壁中的口引入胸腔并通过心脏壁的心外膜表面到心脏内的选定位置。 能量从电阻加热器元件输送到选定的心脏部位以产生血液传导途径和/或刺激血管发生。
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2.发明授权公开(公告)号：US06176856B1
公开(公告)日：2001-01-23
申请号：US09215110
申请日：1998-12-18
IPC分类号： A61B1804
CPC分类号： A61B18/04 , A61B2017/00247 , A61B2018/00392
摘要： A catheter system with an outer catheter body defining at least one lumen and an inner catheter body defining at least one lumen with proximal and distal portions. An introducer is coupled to the distal portion of the inner catheter body. The introducer has a tissue piercing distal end. A resistive heater element is positioned in the introducer. The outer catheter is introduced into a patient's vasculature. The inner catheter is then introduced through the lumen of the outer catheter to a selected heart site. The tissue piercing distal end of the introducer is then advanced into an interior of the heart at the selected heart site. Energy is delivered to the selected heart site from the resistive heater element to create a blood conducting pathway and/or stimulate angiogenesis. In an alternative embodiment, a heart treatment apparatus includes a handpiece with a proximal and a distal end and an elongated member defining at least one lumen coupled to the handpiece distal end. The elongated member has a distal end and an introducer coupled to the distal end. The introducer has a tissue piercing distal end. A resistive heater element is positioned in the introducer. The tissue piercing distal end is introduced through a port in the chest wall into a chest cavity and through an epicardial surface of the heart wall to a selected site within the heart. Energy is delivered to the selected heart site from the resistive heater element to create a blood conducting pathway and/or stimulate angiogenesis.
摘要翻译： 具有限定至少一个内腔的外导管主体的导管系统和限定具有近端部分和远端部分的至少一个内腔的内导管主体。 引导器联接到内导管主体的远端部分。 导引器具有组织穿刺远端。 电阻加热器元件位于导引器中。 将外导管引入患者的脉管系统。 然后将内导管通过外导管的内腔引入选定的心脏部位。 然后导引器的组织穿刺远端在选定的心脏部位进入心脏的内部。 能量从电阻加热器元件输送到选定的心脏部位以产生血液传导途径和/或刺激血管发生。 在替代实施例中，心脏治疗装置包括具有近端和远端的手持件和限定连接到手持件远端的至少一个腔的细长构件。 细长构件具有远端和连接到远端的导引器。 导引器具有组织穿刺远端。 电阻加热器元件位于导引器中。 组织穿刺的远端通过胸壁中的口引入胸腔并通过心脏壁的心外膜表面到心脏内的选定位置。 能量从电阻加热器元件输送到选定的心脏部位以产生血液传导途径和/或刺激血管发生。
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公开(公告)号：US06551302B1
公开(公告)日：2003-04-22
申请号：US09697672
申请日：2000-10-26
申请人： Michael J. Rosinko , Alexander Khairkhahan , Michael Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
发明人： Michael J. Rosinko , Alexander Khairkhahan , Michael Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
IPC分类号： A61M3100
CPC分类号： A61M25/0147 , A61B8/06 , A61B8/12 , A61M25/0084 , A61M25/0136 , A61M2025/0089
摘要： A steerable percutaneous catheter for guiding at least one functional device to selected surfaces of a body for treatment thereon, particularly adapted for laser-assisted Percutaneous Transmyocardial Revascularization (PTMR). The steerable catheter has a handle portion at its proximal end and a controllably deflectable end portion at its distal end. The distal end of the catheter and the distal end of the functional device maintain alignment automatically during deflection. The invention also includes a surface contact detection system to detect contact with an interior body surface, such as the heart wall.
摘要翻译： 一种可导向的经皮导管，用于将至少一个功能装置引导到身体的选定表面上用于在其上进行治疗，特别适用于激光辅助经皮心肌血运重建术（PTMR）。 可操纵的导管在其近端处具有手柄部分，在其远端具有可控制地偏转的端部。 导管的远端和功能装置的远端在偏转期间自动保持对准。 本发明还包括一个表面接触检测系统，用于检测与诸如心脏壁的内部身体表面的接触。
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公开(公告)号：US6056742A
公开(公告)日：2000-05-02
申请号：US852011
申请日：1997-05-06
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2017/00973 , A61B2018/00392
摘要： Apparatus for treating a patient's heart by stimulating revascularization of the heart or creating channels in the heart. The apparatus includes a catheter, a laser energy source coupled to the catheter, and a control circuit. The control circuit is configured to cause the laser energy source to deliver an output of laser energy over a first time period shorter than a heart beat cycle.
摘要翻译： 用于通过刺激心脏血运重建或在心脏中产生通道来治疗患者心脏的装置。 该装置包括导管，耦合到导管的激光能量源和控制电路。 控制电路被配置为使得激光能量源在比心跳周期短的第一时间段内传递激光能量的输出。
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公开(公告)号：US08573027B2
公开(公告)日：2013-11-05
申请号：US12714299
申请日：2010-02-26
IPC分类号： G01F25/00
CPC分类号： G01F11/08
摘要： A novel enhanced flow metering device is adapted for disposing into a flow material reservoir a known volume of flow material whereby software used in conjunction with a pressure sensor may be calibrated. Additionally, by measuring the known amount of flow material returning to the flow material reservoir, checks are quickly made to ensure the pressure sensor is behaving as expected.
摘要翻译： 一种新颖的增强型流量计量装置适于将已知体积的流动材料设置在流动材料储存器中，由此可以校准与压力传感器结合使用的软件。 此外，通过测量返回到流动材料储存器的已知流量材料的量，快速进行检查以确保压力传感器按预期的方式行为。
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公开(公告)号：US06863653B1
公开(公告)日：2005-03-08
申请号：US09169747
申请日：1998-10-09
CPC分类号： A61B18/20 , A61B18/24 , A61B2017/00106 , A61B2017/00247 , A61B2017/22072 , A61B2018/00392 , A61B2018/00636
摘要： An apparatus for treatment of body tissue includes a treatment apparatus configured to be inserted into a patient. The treatment apparatus has a distal portion, a distal end, a proximal portion and an axis. An ultrasound transducer is positioned at the distal portion of the treatment apparatus. The ultrasound transducer includes a distal ultrasound energy delivery surface and a proximal ultrasound energy delivery surface. An ultrasound energy attenuator member is positioned adjacent to the proximal ultrasound energy delivery surface and is made of a material to at least partially attenuate ultrasound energy from the proximal ultrasound energy delivery surface.
摘要翻译： 用于治疗身体组织的装置包括构造成插入患者体内的治疗装置。 治疗装置具有远侧部分，远端，近端部分和轴线。 超声换能器位于治疗装置的远端部分。 超声换能器包括远端超声能量输送表面和近端超声能量输送表面。 超声能量衰减器构件邻近近端超声能量输送表面定位，并且由至少部分地衰减来自近端超声能量输送表面的超声能量的材料制成。
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7.发明授权公开(公告)号：US06391021B1
公开(公告)日：2002-05-21
申请号：US09327938
申请日：1999-06-08
IPC分类号： A61B1824
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2017/00703 , A61B2018/00392
摘要： A method of selecting laser parameters for performing laser-assisted myocardial revascularization to avoid inducing undesired cardiac arrhythmia without synchronization of delivery of laser energy and the patient's cardiac cycle, the method comprising the steps of minimizing the power level of laser energy used, thereby decreasing the overall trauma to the heart, selecting a pulse frequency as great as possible while avoiding adverse summation effects, selecting a pulse width as wide as possible to prevent excessively high peak powers per pulse and not so wide as to cause undesired thermal damage, selecting an energy flux rate, shaping the front end of each pulse of laser energy to provide efficient, non-explosive TMR channeling, and correcting the selected power level, pulse width, pulse frequency and energy flux rate for mechanical events, including method of access to the heart, position of selected portions of myocardium in the heart, temporal duration of the procedure, natural movement of the heart, specific heart geometry, pre-existing heart arrhythmia and other factors causing a predisposition to heart arrhythmia. A method for performing laser-assisted transmyocardial revascularization (TMR) and percutaneous transluminal myocardial revascularization (PTMR) using such laser energy with parameters selected to avoid inducing undesired cardiac arrhythmia, the method comprising the steps of generating laser energy having a predetermined non-square wave shape, a predetermined wavelength, a predetermined energy flux and a predetermined power level, and delivering the laser energy in a plurality of pulses, the plurality of pulses having a predetermined pulse frequency and a predetermined pulse width, to selected portions of myocardium to form TMR and PTMR channels without synchronizing delivery of the laser beam with the cardiac cycle.
摘要翻译： 选择用于执行激光辅助心肌血运重建的激光参数以避免诱导不需要的心律失常而不发送激光能量和患者的心动周期的方法，所述方法包括以下步骤：使所使用的激光能量的功率水平最小化，从而减少 对心脏的整体创伤，尽可能选择脉冲频率，同时避免不利的相加效应，尽可能选择尽可能宽的脉冲宽度，以防止每个脉冲过高的峰值功率，而不是很宽，从而导致不必要的热损伤，选择能量 通量速率，对激光能量的每个脉冲的前端进行整形，以提供有效的非爆炸性TMR通道，并且对机械事件的选择功率电平，脉冲宽度，脉冲频率和能量通量率进行校正，包括进入心脏的方法 心脏心脏选择部位的位置，手术的时间持续时间，自然运动 心脏的特征，特定的心脏几何形状，预先存在的心律失常等导致心律失常倾向的因素。 一种使用具有选择的参数的激光能量进行激光辅助心肌血运重建术（TMR）和经皮腔内心肌血运重建术（PTMR）的方法，该方法包括以下步骤：产生具有预定非方波的激光能量 形状，预定波长，预定能量通量和预定功率电平，并将激光能量以预定的脉冲频率和预定脉冲宽度的多个脉冲输送到心肌的选定部分以形成TMR 和PTMR通道，而不使激光束与心动周期同步传送。
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8.发明授权Systems and methods for identifying and controlling interfaces between blood components 失效识别和控制血液成分之间界面的系统和方法
公开(公告)号：US5565977A
公开(公告)日：1996-10-15
申请号：US482363
申请日：1995-06-07
申请人： Michael J. Rosinko
发明人： Michael J. Rosinko
CPC分类号： G01N15/05 , G01N33/491
摘要： Systems and methods locate at least three spaced apart sensing units in association with volume of blood comprising a first blood component region, a second blood component region, and an interface region between the first and second blood component regions. The systems and methods locate at least one of the sensing units so that its optical field lies above the interface region and at least one of the sensing units so that its optical field lies below the interface region. Each sensing unit senses the attenuation of energy emitted into blood in its optical field and generates a signal relating to the attenuation. The systems and methods convert the signals to a signal vector of signal values having a shape approximated by a function. The systems and methods normalize the signal vector, and also create a vector of convolution signal values by multiplying the normalized signal vector by the function. The systems and methods identify the sensing unit associated with the highest convolution signal value. It is this sensing unit that lies closest to the interface. The systems and methods can limit the signal values of the signal vector according to prescribed criteria that eliminate the effect of noise.
摘要翻译： 系统和方法与血液体积相关联地设置至少三个间隔开的感测单元，其包括第一血液成分区域，第二血液成分区域以及第一和第二血液成分区域之间的界面区域。 这些系统和方法将至少一个感测单元定位成使得其光场位于界面区域上方，并且至少一个感测单元使得其光场位于界面区域之下。 每个感测单元感测在其光场中发射到血液中的能量的衰减，并产生与衰减有关的信号。 系统和方法将信号转换成具有由函数近似的形状的信号值的信号向量。 系统和方法对信号向量进行归一化，并通过将归一化信号向量乘以函数来创建卷积信号值向量。 系统和方法识别与最高卷积信号值相关联的感测单元。 这个感应单元最接近接口。 系统和方法可以根据消除噪声影响的规定标准来限制信号矢量的信号值。
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公开(公告)号：US20100218586A1
公开(公告)日：2010-09-02
申请号：US12714299
申请日：2010-02-26
CPC分类号： G01F11/08
摘要： A novel enhanced flow metering device is adapted for disposing into a flow material reservoir a known volume of flow material whereby software used in conjunction with a pressure sensor may be calibrated. Additionally, by measuring the known amount of flow material returning to the flow material reservoir, checks are quickly made to ensure the pressure sensor is behaving as expected.
摘要翻译： 一种新颖的增强型流量计量装置适于将已知体积的流动材料设置在流动材料储存器中，由此可以校准与压力传感器结合使用的软件。 此外，通过测量返回到流动材料储存器的已知流量材料的量，快速进行检查以确保压力传感器按预期的方式行为。
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公开(公告)号：US06493575B1
公开(公告)日：2002-12-10
申请号：US09326128
申请日：1999-06-04
IPC分类号： A61B600
CPC分类号： A61B90/36 , A61B6/12 , A61B6/4441 , A61B6/547 , A61B6/584 , A61B90/39 , A61B2017/00247 , A61B2018/00392 , A61B2090/376 , A61M25/0108
摘要： A catheter tracking system for visualization of fluoroscopic images, the system comprising a fluoroscope for generating fluoroscopic image data, a fluoroscopic image visualization monitor, a catheter having an elongated shaft, particularly an intraventricular catheter, distal tip and a radio opaque portion adjacent the distal tip. A circumferential radio opaque band may be used to determine the relative position, orientation and motion of the catheter. An image analysis system capable of analyzing the image of the catheter and the radio opaque band, for receiving fluoroscopic image data from the fluoroscope determining physical parameters related to the left ventricle, and the relative position, orientation and motion of the catheter therein, and for determining the location and other parameters of treatment on intraventricular surfaces.
摘要翻译： 一种用于荧光透视图像可视化的导管跟踪系统，该系统包括用于产生荧光透视图像数据的荧光镜，荧光透视图像可视化监视器，具有细长轴，特别是心室内导管的导管，远端尖端和邻近远侧尖端的不透射线部分 。 可以使用周向无线电不透明带来确定导管的相对位置，取向和运动。 一种能够分析导管和无线电不透明带的图像的图像分析系统，用于从荧光镜接收荧光镜图像数据，确定与左心室相关的物理参数，以及其中导管的相对位置，取向和运动，以及 确定心室内表面治疗的位置和其他参数。
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